Networked inbox

ABSTRACT

A computer-implemented electronic messaging method and system, the method comprising the steps of receiving an electronic message at a first system, the electronic message comprising a healthcare provider type, obtaining contextual information associated with the electronic message at the first system, using the healthcare provider type and the contextual information to identify an intended recipient address for an intended healthcare provider recipient for the electronic message and providing the intended recipient address to facilitate delivery of the electronic message to the intended healthcare provider recipient.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.14/329,222, filed Jul. 11, 2014, which is a continuation of U.S.application Ser. 12/987,252, filed Jan. 10, 2011, which issued as U.S.Pat. No. 8,812,599 on Aug. 19, 2014, all of which are incorporatedherein by reference.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT

Not applicable.

BACKGROUND OF THE INVENTION

Field of the Invention

The present invention relates to electronic messaging between twoentities and specifically to sending messages from one entity to anotherthat leverages information stored by one of the entities and contextualinformation associated with the message to identify an intended unknownmessage recipient.

Description of the Related Art

In the medical industry it is often the case that patients see manydifferent physicians, medical assistants, nurses, specialists, etc., inthe course of receiving services. Thus, for instance, a patient mayinitially consult a primary care physician about an ailment, be referredout for tests and imaging activities to one or several differentinstitutions and be referred to one or more specialists, for additionalservices. Here, in order to provide optimal service for a patient, allcaregivers that provide services to a patient need to be able to easilycommunicate amongst themselves. One way for caregivers to communicatebetween themselves is via an electronic messaging system.

Typical electronic messaging systems allow one user to send a message toa second user by addressing the message to a specified addressassociated with the second user. For example, in an e-mail system, eachindividual user has their own specific address. The e-mail address isusually in the form of: username@domainname. Thus, a user of GMAIL.COMwith a user name of “john.smith” would have an e-mail address of“john.smith@gmail.com”.

It is known that an administrator can establish a single e-mail addressthat can be routed to a number of different recipients by an e-mailserver. For example, a company might have a single customer servicee-mail address such as customer.service@company.com. A server associatedwith the customer service e-mail address forwards messages received atthe customer service address to a number of different e-mail accounts ofemployees responsible for monitoring customer service questions. Themessage is thus distributed to several customer service employeesindiscriminately. The company can then use the customer service e-mailaddress in its product literature so that questions from customers orthe general public can be handled without concerns about changes at thecompany itself: employee turn over, vacations, etc. Furthermore, theactual recipients of the messages can remain generally unknown to thesender at the time the sender sends the electronic message.

While the single e-mail address concept works well for routing messagesto a group of intended recipients, unfortunately there is no easy way touse a similar single e-mail address to route a message to one of aplurality of possible recipients. For instance, in a case where an ear,nose and throat (ENT) specialist intends to route a message to apatient's primary care physician (PCP) and does not know the PCP's nameor e-mail address, there is no easy way for the ENT specialist toaddress an e-mail to a single PCP address and have the messaging systemdeliver the message to the patient's PCP. Similarly, where a patient'sPCP intends to route a message to the patient's ENT specialist and doesnot know who the specialist is or the specialist's e-mail address,currently there is no way for the PCP to address a message to a singleaddress and have the message automatically delivered to the patient'sENT specialist. This problem is exacerbated in cases where patients areserviced by many different physicians and across unaffiliated entitieswhere familiarity between all caregivers and addressing conventions ishighly unlikely.

BRIEF SUMMARY OF THE INVENTION

It has been recognized that even when a message sender does not haveenough information or access to information usable to identify anintended recipient of a message and/or the recipient's e-mail address, asystem can be set up that can use a short descriptor of the recipientand additional contextual information associated with a message toidentify an intended recipient. Here, the short recipient descriptoralone is insufficient for the system to identify the intended recipientaddress but the short recipient descriptor along with the contextualinformation is sufficient to identify the recipient address.

For instance, where an ENT specialist is working in a patient's medicalrecord chart when the specialist decides to send an e-mail to thepatient's PCP, the specialist may be able to simply fill in PCP in the“To” field of an e-mail template. When PCP is typed into the “To” field,a server may be programmed to identify a PCP associated with the patientthat is associated with the currently viewed chart, identify anelectronic messaging system address for the PCP and fill in the PCPaddress automatically. In this case, “PCP” is the short recipientdescriptor and the patient identifier operates as the contextualinformation used along with the recipient descriptor to automaticallyidentify the recipient's address.

In other embodiments, after an e-mail targeting PCP is composed, priorto transmission, a patient identifier may be added to the e-mail in somefashion that identifies the patient associated with the chart accessedwhen the e-mail was composed. Here, the patient identifier again servesas contextual information associated with the e-mail being composed.Upon receiving the e-mail with the patient identifier, receiving e-mailserver may then use the PCP identifier and the patient identifier toidentify a PCP associated with the patient, identify an address for thePCP and forward the e-mail message to the intended PCP.

In still other embodiments, after PCP is entered in a “To” e-mail fieldwhile a patient chart is being examined by an ENT specialist and priorto transmitting the e-mail, a pre-e-mail may automatically betransmitted to at least a subset of servers including the PCP shortrecipient identifier and a patient identifier associated with thepatient's chart being viewed when PCP was entered in the “To” field. Inresponse, each receiving e-mail server may use the PCP identifier andpatient identifier to attempt to identify the patient's PCP. Where aserver identifies the patient's PCP address, the server automaticallytransmits the PCP address back to the specialist's e-mail server. Thespecialist's e-mail server then can either automatically fill in the PCPaddress in the “To” field, associate the PCP address with the “To” fieldor provide an option for the specialist to select the PCP address tofill in the “To” field.

In other embodiments, where a specialist fills “PCP” into a “To” fieldand then transmits an e-mail prior to the PCP address being resolved, ifa receiving e-mail server cannot resolve a unique intended recipientusing the PCP descriptor and other contextual information, the servermay respond with either an error message or, in the case where two or asmall subset of possible intended recipients is resolvable, may providea list of possible intended recipients for the specialist to choosefrom. When a list of possible intended recipients is presented and oneis selected, the e-mail is then delivered to the selected recipient.

In still other embodiments it is contemplated that contextualinformation may be gleaned from some part of an e-mail as opposed tobeing obtained from a currently viewed patient's chart. For instance, itmay be required practice for a physician to enter a unique patientidentifier in a “Re” line of an e-mail when communicating with anotherphysician about a patient. In this case, the patient identifier (i.e.,the contextual information) required to identify a patient's PCP may begleaned from the “Re” line of an e-mail and used to resolve an intendedrecipient. Contextual information may be gleaned from other locations aswell. In other embodiments patient information may be added to anattachment or the like associated with and transmitted with other e-mailinformation.

Some embodiments include a computer-implemented electronic messagingmethod comprising the steps of receiving an electronic message at afirst system, the electronic message comprising a caregiver type,obtaining contextual information associated with the electronic messageat the first system, using the caregiver type and the contextualinformation to identify an intended recipient address for an intendedcaregiver recipient for the electronic message and providing theintended recipient address to facilitate delivery of the electronicmessage to the intended caregiver recipient.

In some cases the step of obtaining contextual information associatedwith the electronic message includes obtaining a patient identifieridentifying a patient associated with the electronic message. In somecases the step of obtaining a patient identifier includes obtaining thepatient identifier from a patient chart.

In some cases the step of obtaining the patient identifier from apatient chart includes obtaining the patient identifier from a patientchart most recently accessed by a caregiver composing the electronicmessage. In some cases the step of obtaining a patient identifierincludes gleaning the identifier from information in the electronicmessage.

In some cases the step of using the caregiver type and the contextualinformation to identify an intended recipient address for an intendedcaregiver recipient for the electronic message includes the steps ofassociating a patient chart with the electronic message, identifying acaregiver of the caregiver type indicated in the patient chart andidentifying an electronic address for the identified caregiver. In somecases the step of receiving an electronic message at a first systemincludes composing the electronic message at a second system where theelectronic message specifies the caregiver type and includes thecontextual information and transmitting the electronic message to thefirst system. In some cases the step of receiving an electronic messageat a first system includes receiving the electronic message as themessage is entered and prior to transmission of the electronic message.In some cases the electronic message is composed using the first system.

In some cases the electronic message is composed using a second systemseparate from the first system and wherein the step of receiving theelectronic message includes receiving the electronic message from thesecond system at the first system. In some cases the caregiver type isselected from the group consisting of: doctor, pediatrician, primarycare physician, radiologist, specialist, pharmacist, and surgeon. Insome cases the caregiver type is a generic type.

In some cases the step of providing the intended recipient addressincludes automatically inserting the intended recipient address in anaddress field in the electronic message. In some cases the step ofproviding the intended recipient address includes presenting theintended recipient address for selection as a target address for theelectronic message.

Other embodiments include a networked messaging system comprising afirst medical record system comprising patient records and caregiverrecords and a first computer system communicatively linked to the firstmedical record system, the first computer system programmed to performthe steps of receiving an electronic message, the electronic messagecomprising a caregiver type, obtaining contextual information associatedwith the electronic message, using the caregiver type and the contextualinformation to identify an intended recipient address for an intendedcaregiver recipient for the electronic message and providing theintended recipient address to facilitate delivery of the electronicmessage to the intended caregiver recipient.

In some cases the system is programmed to perform the step of obtainingcontextual information associated with the electronic message byobtaining a patient identifier identifying a patient associated with theelectronic message. In some cases the system is programmed to performthe step of obtaining a patient identifier by obtaining the patientidentifier from a patient chart. In some cases the system is programmedto perform the step of obtaining the patient identifier from a patientchart by obtaining the patient identifier from a patient chart mostrecently accessed by a caregiver composing the electronic message.

In some cases the system is programmed to perform the step of obtaininga patient identifier by gleaning the identifier from information in theelectronic message. In some cases the system is programmed to performthe step of using the caregiver type and the contextual information toidentify an intended recipient address for an intended caregiverrecipient for the electronic message by associating a patient chart withthe electronic message, identifying a caregiver of the caregiver typeindicated in the patient chart and identifying an electronic address forthe identified caregiver. In some cases the system is programmed toperform the step of receiving an electronic message at a first system byreceiving the electronic message from a second system used to composethe electronic message where the electronic message specifies thecaregiver type and includes the contextual information.

In some cases the system is programmed to perform the step of receivingan electronic message at a first system by receiving the electronicmessage as the message is entered and prior to transmission of theelectronic message. In some cases the electronic message is composedusing the first system. In some cases the electronic message is composedusing a second system separate from the first system and wherein thestep of receiving the electronic message includes receiving theelectronic message from the second system at the first system. In somecases the caregiver type is selected from the group consisting of:doctor, pediatrician, primary care physician, radiologist, specialist,pharmacist, and surgeon.

In some cases the step of providing the intended recipient addressincludes automatically inserting the intended recipient address in anaddress field in the electronic message. In some cases wherein the stepof providing the intended recipient address includes presenting theintended recipient address for selection as a target address for theelectronic message.

Still other embodiments include a computer-implemented electronicmessaging method, the method comprising the steps of receiving a generalrecipient descriptor at a first system where the general recipientdescriptor is associated with an electronic message and the generalrecipient descriptor is descriptive of a plurality of different possibleintended message recipients, obtaining contextual information associatedwith the electronic message, using the general recipient descriptor andthe contextual information to identify an intended message recipientaddress; and providing the intended message recipient address tofacilitate delivery of the electronic message to the intended messagerecipient.

These and other objects, advantages and aspects of the invention willbecome apparent from the following description. In the description,reference is made to the accompanying drawings which form a part hereof,and in which there is shown a preferred embodiment of the invention.Such embodiment does not necessarily represent the full scope of theinvention and reference is made therefore, to the claims herein forinterpreting the scope of the invention.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

FIG. 1 is an exemplary embodiment of a possible messaging system inaccordance with one embodiment of the present invention;

FIGS. 2A-C show exemplary embodiments of possible recipient descriptoraddressing schemes; and

FIG. 3 is a flowchart showing one possible workflow for sending andreceiving an electronic message in accordance with one embodiment of thepresent invention.

DETAILED DESCRIPTION OF THE INVENTION

The present invention is directed to a method of communicating messagesfrom one entity to another wherein the first entity does not know theactual identity and/or electronic address of an intended recipient. Themessaging may be useful in any situation in which one party refersmessages to another such as occur in medical or healthcare, legal,insurance, shipping, inventory management, and other similar fields. Forsimplicity, the following description uses an example of sendingelectronic messages between two medical institutions including St.Mary's Hospital (“St. Mary's”) and a local healthcare cooperative(“LHC”).

In one embodiment, St. Mary's Hospital and LHC have established aninter-institution messaging network 100. The messaging network 120 mayconnect two or more electronic medical records (“EMR”) systems 102 and108 by a communication network 114. Each institution's EMR system 102and 108 contains information regarding a patient including contactinformation, patient medical histories, schedules, visit information,doctors associated with the patient, prescriptions, treatments,emergency contact information, payment information, medical images, andlab results.

The communications network 114 may be implemented across an industrystandard network, including the internet, that permits electronictransmission of information from one server to another. In the case ofelectronic messages between two distinct institutions, the messagingnetwork 100 may comprise at least one messaging or e-mail server 104 and106 at each of the institutions. The communications network 114, ifimplemented on the Internet, may be implemented using a virtual privatenetwork wherein the two messaging servers are treated as if they are ona private network.

Referring still to FIG. 1, devices 110 and 112 are associated with LHC'sand St. Mary's e-mail servers 104 and 106, respectively. Devices 100 and112 are shown as desktop computers but may be any type of interfacedevices such as laptops, wireless phones or smart palm type devices, padtype devices, etc. Each interface device can be used to compose and sendelectronic messages to other devices 110 or 112.

Where a message is sent from one device to another device associatedwith the same entity (e.g., St. Mary's), the message is routed from thesending device to the e-mail server associated with the entity and outto the target device in most cases without transmission through network114. For instance, a message from a first device 112 to a second device112 associated with St. Mary's in FIG. 1 would be routed through server104 without passing through network 114.

Where a message is sent from one device 112 associated with St. Mary'sto another device 110 associated with LCH, the message is routed to St.Mary's e-mail server 104, through network 114 to server 106 which inturn routes the message to the intended recipient address. Here,information in the electronic message assists the sending messagingserver 104 to determine where and how to send the electronic message tothe receiving messaging server 106. A messaging server 104 or 106 mayact as both a sending messaging server and a receiving messaging server.

Hereafter, unless indicated otherwise, the phrase “internal message”will be used to refer to a message sent from one device to anotherdevice where the sending and receiving devices are served by a singlee-mail server (e.g., 104 or 106). Similarly, the phrase “externalmessage” will be used to refer to a message between devices that areserved by different e-mail servers. For instance, a message between onedevice 112 and another device 110 that are served by servers 104 and106, respectively, would be an external message.

In one exemplary scenario, a physician using a computer 112 at St.Mary's desires to send an external message to another physician orhealthcare professional using a computer 110 at LHC. For example, afirst physician enters information regarding a patient visit into St.Mary's EMR system 102 using his or her computer 112 regarding anemergency room visit. The physician then desires to send some or all ofthe information to the patient's PCP at a local family care clinic runby LHC. It will be appreciated that LHC may be running a different EMRsystem 108 than St. Mary's (i.e., EMR system 102). It will be furtherappreciated that even if the two institutions have an EMR system sold bythe same vendor, the particular instances and implementations may beseparate with separate databases, servers, and patient records.Accordingly, the first physician may not have ready access to either thename of the primary care physician or the electronic message address forthe physician.

In accordance with the present invention, the physician at St. Mary'smay compose an electronic message using St. Mary's EMR system 102 ore-mail system 104 using computer 112. The electronic message may includean address and a patient identifier. Additional information may beincluded with an electronic message such as a subject, a return address,a message body, certain header and routing information, and part or allof a patient medical record. The electronic message of the instantinvention may be implemented using either common electronic messagingschemes including e-mail (e.g., smtp and imap) or a custom messagingsystem.

With reference to FIGS. 2A, an address for an electronic message may bein a form 202 of: recipient@institution. For instance, if the physicianknows the name of the patient's primary care physician is Dr. JohnSmith, the physician could compose the message with an address:john.smith@LHC. In this case, the address is composed of the recipientdesignation 204 and the institution identifier 208 separated by token206 indicated by the “@”.

However, when a physician does not know the name of a patient's PCP ordoes not know the format of an address in the LCH system, as istypically the case for electronic messages sent between two separateinstitutions, the physician using the electronic messaging system 100 ofthe present invention can address the message using a generic or generaldescriptor or identifier 212 and an institution identifier 208 separatedby a token 206 as shown in FIG. 2B. For instance, an exemplarydescriptor of this type may be PCP@LHC. In this case “PCP” is short for“primary care physician.”Similarly, if, instead of the primary carephysician, the physician wanted to send a message to the patient'ssurgeon, the physician could address the message as: surgeon@LHC.Accordingly, the messaging system allows the physician to addresselectronic messages using one of a set of short descriptive generic“caregiver” type identifiers.

In addition, the addressing function can also be short-hand forintra-institution communications or internal messages. For example, evenif the physician could determine a patient's PCP—as either provided byan EMR system or by a patient—the physician can avoid looking up thePCP's address and simply address the electronic message using eithergeneric identifier 212 and institution identifier 208 (e.g.,PCP@stmarys) or, even more simply, using generic identifier 212 (e.g.,PCP). In the second example, the institution identifier 208, “@stmarys”,is implied since the physician is sending the message internally. Inthis case, the address comprises only the caregiver type descriptor.

Similarly, even if a patient's primary care physician is not part of theSt. Mary's EMR system 102, a physician may still be able to address theelectronic message by its generic identifier 212 (e.g., as “PCP”). Inthis case, St. Mary's EMR system 102 may have previously recorded PCPinformation associated with a patient. This information may include boththe name of the patient's PCP and an associated institution.Accordingly, if the EMR system 102 indicates that the patient has a“PCP” at LHC, messages addressed to PCP will be rerouted to “PCP@LHC”.This functionality is described in further detail below with respect tothe routing of electronic messages using information from the EMRsystem.

In at least some embodiments, an electronic message also includes apatient identifier. In one embodiment, the patient identifier is simplya numeric or alpha-numeric key that uniquely identifies a patient recordin an EMR system. However, under the scenario above, St. Mary's EMRsystem 102 and LHC's EMR system 108 may not have common, unique patientrecord identifiers. In this case, one alternative is to create a tokenthat can be included with the electronic message that will be recognizedby a receiving messaging server. In this embodiment, a patient mayprovide the token that can be read and stored by the sender's EMRsystem. For example, the patient may carry a card with the tokenrepresented by a bar code or magnetic strip. The token is read by thephysician's system and the token is stored within the electronic messagesent from St. Mary's and will be used to identify the patient at LHC'smessaging server 106, as further discussed below.

In the case that neither a common, unique identifier or token isavailable, the patient identifier may include a sufficient amount ofcontextual identifying information within the electronic message so thatthe EMR system at the receiving institution can correctly and uniquelyidentify the patient. For example, the electronic message may includeone or more of the following information: first name, last name, date ofbirth, last four digits of a social security number, mother's maidenname, number of children, and place of birth. There are many possiblecombinations of information that may be successfully used as a patientidentifier. This information can be retrieved from a sending party's EMRsystem and incorporated into the electronic message as part of the body,the header, or as an attachment. For instance, in at least someembodiments, when a specialist is using an EMR system to view a patientchart and decides to send an e-mail to the patient's PCP upon opening upan e-mail application to compose the message, the system mayautomatically glean patient identifier information (e.g., a patientidentifier) from the currently opened patient chart and add thatinformation to an e-mail field. As another instance, when a specialistis composing an e-mail to a PCP as indicated by entry of “PCP” in ane-mail “To” field, the system may automatically identify the last tenpatient charts viewed by the specialist and provide a list of tenpatient identifiers for selection by the specialist. Here, uponselection of a patient from the list, a patient identifier would beadded to an appropriate e-mail field.

The electronic message may also include a body that contains the messageto be delivered. The body can be free form text typed by the sender. Itcan also be structured text based on a field or fields in the sender'sEMR system. In the latter case, for example, the body of the electronicmessage can be an automated report filled in using information saved inthe EMR system by the physician. For example, an Emergency Roomphysician may send an electronic message comprising a discharge reportto a patient's PCP. The discharge report can be a template or formdocument in which the information regarding the visit can beautomatically completed by using values stored in St. Mary's EMR system102.

In addition, the electronic message may include part or all of anelectronic medical record. This information may be copied as text intothe body of the electronic message. It can also be attached to theelectronic message as a file attachment. It may also be attached as anelectronic link. The electronic link provides information for acommunications protocol whereby the receiving system can remotelyretrieve information from the sender's EMR system.

In the context of an EMR system, it is contemplated that the functionsfor sending and receiving messages in an electronic messaging system 120of the present invention may be incorporated directly into the EMRsystem. In this case, the electronic messaging system 120 has readyaccess to the patient's medical record information while the messagingis being prepared and before it is sent.

In at least some embodiments, when a sender finishes an electronicmessage and sends it, the message is provided to the sender's messagingserver 104. The sender's messaging server 104 is responsible for routingthe message to the recipient's messaging server via the communicationsnetwork 114. The process of routing may involve obtaining the externaladdress of the recipient's messaging server 106, preparing theelectronic message for transmission across the communications network114, encrypting the electronic message, and actually sending theelectronic message.

In the case of an “external” message, (i.e., a message addressed to anentity outside the sender's EMR system 102), the sender's messagingserver 104 must determine the address of the external entity byexamining the address in the e-mail. In the above example addressed to“PCP@LHC” the sender's messaging server 104 must first determine whereand what institution identifier 208, “LHC,” means. The sender'smessaging server 104 or the sender's EMR system 102 may be programmed sothat an “institution” named “LHC” points at the server address of thelocal health cooperative. This information may be indexed by the name“LHC.” The server address may be an internet protocol address (“IP”address) or other uniform resource indicator (“URI”) that includesprotocol, IP address, and port number and other communicationinformation. The server address could also be an internet domain such as“localhealthcooperative.org.” If the institution is found, the messageis routed using an appropriate communications protocol. If noinstitution is found, then the messaging server may return the messageto the sender. The return message may include information that no suchinstitution is found. Alternatively, or in addition to returning themessage to the sender, the message could be sent to an assistant orother specialist at the sender's institution for proper addressinginformation.

In addition, as noted above, another embodiment of the present inventionmight have a situation in which the sender addresses a message withoutan institution identifier 208 (e.g., “PCP”), where the sender's EMRsystem 102 has a record in a patient chart indicating that the genericidentifier “PCP” is, in fact, an external entity. In this case, uponretrieving the destination information for “PCP” from the patient recordfor the patient matching the patient identifier, the message is reroutedby the sending messaging server 104 using the proper institution. Forexample, if the EMR system 102 identifies that a PCP is at LHC, then themessage is not delivered internally, but the address is changed to“PCP@LHC” and resent. Alternatively, if the EMR system 102 has thecomplete address for the primary care physician, Dr. John Smith havingan address john.smith@ localhealthcooperative.org, then the message canbe sent directly to that address avoiding additional processing by boththe sending EMR system 102 and receiving EMR system 108.

With respect to both internal messaging and the situation in which asending EMR system 102 contains some or all of the relevant contactinformation, the sender user interface can implement the appropriateaddressing queries directly. For example, as the Emergency Roomphysician types “PCP” into the address field of a message compositionscreen on computer 112, the user interface software can search the EMRsystem 102 for any corresponding record. As discussed above, a messagemay be composed in the context of a patient record and, therefore, themessaging system 100 may have ready access to information in the EMRsystem 102. Accordingly, the user interface software can pass both thegeneric identifier “PCP” and a patient identifier directly to the EMRsystem 102 in order to retrieve the corresponding results. If the EMRsystem 102 returns the destination address ofjohn.smith@localhealthcooperative.org, for example, then the address of“PCP” can be replaced with john.smith@localhealthcooperative.org.

In the context of an “external” message, the sending messaging server104 is responsible for sending the electronic message across thecommunications network 114 to the receiving messaging server 106. Uponreceiving the message, the receiving messaging server 106 will firstdetermine the proper recipient of the electronic message. It will beappreciated that “PCP” or “doctor” or “surgeon” and other caregivertypes potentially identify a large number of users of the receivinginstitution's EMR system 108, but only a few or perhaps one will beassociated with a particular patient. Accordingly, a system of thepresent invention may select from among all the possible recipients onlythose that correspond to the patient identifier. In other words, thecombination of caregiver type and the patient identifier will select asubset of all possible caregivers at a receiving institution. As aresult, a select group of all users of the corresponding caregiver typeis set as the actual intended recipient(s). So, for example, if thereare 1000 doctors that are in the category of “primary care physician” atLHC, and the patient has only one primary care physician, then theelectronic message addressed to PCP@LHC for this patient will bedelivered only to the one designated primary care physician, not everyprimary care physician.

In one embodiment, a receiving messaging server 106 will query the EMRsystem 108 for the address information of the caregiver corresponding toboth the patient identifier and the caregiver type. In the case that thepatient identifier is a token or a common, unique identifier, thepatient record may be retrieved directly from the EMR system 108. In thecase that the electronic message only includes patient information, thereceiving messaging server 108 uses some or all of the supplied patientinformation in the electronic message to identify a single patient inthe receiving messaging server's 106 EMR system 108. In any case, if apatient record is successfully retrieved and a corresponding caregiveris found, then the message is routed, by the receiving messaging server106, to the intended recipient's computer 110.

In a possible embodiment, the receiving messaging server 106 may alsoreturn to the sending messaging server 104 an acknowledgement that themessage was successfully received. The acknowledgement may also includethe address information of the intended recipient. The sending messagingserver 104 then may use the information in the acknowledgement to updateits own EMR system 102. In this case, any future messages to thepatient's primary care physician, for example, can be routed directly tothe PCP without requiring additional processing by the receivingmessaging server 106. The acknowledgement itself may also be sentdirectly to the sender or saved to the EMR system 102 for futurereference.

If, however, the receiving messaging server 106 cannot find either acorresponding patient or a corresponding caregiver, an undeliverablemessage may be returned to the sending messaging system 104. Similarly,if the receiving messaging server 106 is unable to identify a singlepatient from the receiving messaging server's EMR system 108, thereceiving messaging server 106 may also return an undeliverable message.In the latter case, it will be understood that both the sending andreceiving institutions may want to guard a patient's privacy and, thus,it may be inappropriate to send a message to more than one patient. Thesending messaging server 104 can forward the undeliverable message tothe sender for additional action. In some embodiments, the undeliverablemessage may include which information failed: i.e., “no such patient,”“no such caregiver,” “patient no longer member of this institution,”etc.

Alternatively, instead of or in addition to returning an undeliverablemessage, the receiving messaging server 106 may also query its own EMRsystem 108 for additional information. For example, if the EMR system108 contains a record for the patient but notes that the primary carephysician is at another institution, then the receiving messaging server106 can return such information to the sending messaging server 106. Inaddition, the receiving messaging server could reroute the electronicmessage to the correct institution using the messaging system.

The system of the present invention also contemplates more complicatedrouting routines for use with generic caregiver types. The genericcaregiver types could include things like “specialist” or “surgeon” or“nurse.” In the case of specialist, any particular hospital or medicalsystem could have hundreds of types of specialists: cardiac, pulmonary,ENT, endocrinology, anesthesiology, podiatry, etc. Such namingconventions may be inconsistent as between institutions and the addressinformation may not be readily apparent or accessible for a userattempting to send a message. A system in accordance with the presentinvention can use information present in the associated medical recordsto correctly select an intended message recipient from among all of thespecialists. For example, if the patient were admitted to St. Mary'sEmergency room for complications related to a patient's diabetes, theEmergency Room physician may want to send a message to the patient'sendocrinologist at LHC. However, instead of writing“endocrinologist@LHC” the emergency room physician can simply type anaddress such as “specialist@LHC.” In this case, the electronic messagefurther contains information regarding the admission to the emergencyroom regarding diabetes. Such information could include the fact of thevisit, vital medical information, the problem, and the medicine ortreatments prescribed, and other customary information. The receivingmessaging server 106 then could use the “problem,” or such otherappropriate indicator, identified as “diabetes complications” to selecta patient's diabetes specialist from among all of a patient'sspecialists.

In another embodiment, the caregiver type may be associated with morethan one recipient. For example, in the endocrinologist example above,the specialist for endocrinology may also be associated with thepatient's diabetes nurse educator, nutritionist, and primary carephysician. In this case, when the receiving messaging server 106 queriesthe EMR system 108 for the diabetes specialist, more than one recipientis returned. The message may then be forwarded to all of the recipientsin at least some embodiments. Similarly, in the case of a surgery orother similar event, a message directed to “surgeon” or “surgery” andreferencing a particular operation may be delivered to all or a subsetof the people associated with that surgery, e.g, a surgeon, a surgicalassistant, an anesthesiologist, etc.

In still other cases, a list of possible patient specific possibleintended recipients may be automatically provided for a physician tochoose from. For instance, when “specialist” is entered in an addressfield, the inventive system may identify a list of five differentspecialists associated with a patient that is associated with themessage being composed. Here the list of five specialists is provided,and one or more may be chosen as intended recipients. Upon selection,recipient addresses are used to replace the “specialist” designation.

A similar result is possible for ordering labs, medical images orprescriptions. In the case of a pharmacy, a physician can use anelectronic message to deliver prescriptions or instructions to thepatient's designated pharmacy. In this case, addressing a message to“pharmacy” or “pharmacy@LHC” can route message information to thepatient's designated pharmacist. In some cases, if special approval isneeded, the receiving messaging system could determine that, not onlyshould the designated pharmacy/pharmacist receive the message, but thatthe patient's PCP should receive a message in order to maintain theprimary care physician's EMR system updated.

In another embodiment of the present invention, the electronic messagemay also include part or all of a patient's electronic medical recordfrom the sender's EMR system 102. The receiving messaging server 106 canthen incorporate that information into its own EMR system 108. Forexample, if the Emergency Room physician attached a visit record fromthe emergency room visit to an electronic message, the receivingmessaging server 106 may desire to incorporate information regardingthat visit into its own EMR system 108. It could, for example, recordinformation about the fact of the visit, the date of the visit, theproblems, the doctor, the treatment and any corresponding prescriptionsdirectly into its own electronic medical records. In one embodiment,this information will be included automatically. In another embodiment,only certain portions of the medical record will be incorporated intothe receiving messaging system's 106 EMR system 108.

Furthermore, the electronic message may include additional attachmentsor documents that the receiving messaging system may wish to retain inits own medical records system. For example, if the sending institutionis a radiology clinic and the electronic message is sent to the primarycare physician, the electronic message may include copies of x-rays orMRI scans. In one embodiment, the electronic message could identify suchattachments accordingly, and the receiving messaging system mayautomatically store such documents to the corresponding location in itsown EMR system. In addition, in order to prevent duplication of images,the receiving messaging system could strip the attachments from theelectronic message before forwarding the messages to the intendedrecipients and include, rather than a complete image file, a link to thelocation in the EMR system.

In another embodiment, the electronic message, its contents andattachments, or any combination thereof may be encrypted by the sendingmessaging server. In order to protect patient privacy and patientmedical and health information, the electronic message may be encryptedusing one or more forms of known encryption methods. In one possibleembodiment, the sending and receiving messaging servers have a sharedencryption key. If a messaging server can send messages to more than oneother messaging server, the messaging server may store differentencryption keys for each of the messaging servers with which it cancommunicate. The sending messaging server then, before sending theelectronic message, can encrypt the electronic message using the sharedencryption key. The information is then transmitted to the receivingmessaging server. The receiving messaging server then can retrieve theshared encryption key associated with the sending messaging server anddecrypts the electronic message.

Each messaging server 104 or 106 may be a general purpose computerserver. The computer server includes a receiving means for receiving anelectronic message and a sending means for forwarding the electronicmessage to its intended recipient or recipients. The receiving meanscomprises a processor and memory unit for executing a software programor algorithm to receive an electronic message. The receiving means mayfurther include a network connection for connecting to thecommunications network. The networking connection may be a network cardthat is connected to the communications network. In the alternative, thereceiving means may comprise a communicative link to a database systemor EMR system for receiving a message sent internally. The software isprogrammed to accept incoming electronic message. The software may be anindustry standard e-mail software server running an industry standarde-mail protocol such as SMTP or IMAP. Alternatively, the softwareprogram may be a messaging system integrated with the EMR system forexchanging messages. This software program may be implemented so as tomonitor the communications network for traffic on a specific port.

The sending means comprises a processor and memory unit for executing asoftware program or algorithm to send an electronic message. It may alsofurther comprise a network connection for the purpose of sendingelectronic message external to the messaging system. The networkconnection may be a networking card connected to the communicationsnetwork. In the alternative, the sending means may comprise acommunicative link to a database system or EMR system for storing amessage sent internally. The software may be an industry standard e-mailsoftware server running an industry standard e-mail protocol such asSMTP or IMAP. Alternatively, the software program may be a messagingsystem integrated with the EMR system for exchanging messages. Thissoftware program may be implemented so as to monitor the communicationsnetwork for traffic on a specific port.

The messaging system further comprises a patient record retrievingmeans. The patient record retrieving means comprises a processor, memoryunit and a communicative link to a disk. The disk may be located locallyon the messaging system or at a remote database or EMR system.Accordingly, the communicative link may be a physical connection withthe messaging system, a network connection, or a high speed deviceconnection (firewire, USB, or similar). The disk stores one or morepatient records. The messaging system is programmed to retrieve patientrecords from the disk using standard database operations or diskoperations. For instance, if the disk has a relational database, themessaging system is programmed to query the database using the patientidentifier to retrieve the corresponding patient record.

The messaging system further comprises a caregiver record retrievingmeans. The caregiver record retrieving means comprises a processor, amemory unit and a communicative link to a disk. The disk may be locatedlocally on the messaging system or at a remote database or EMR system.Accordingly, the communicative link may be a physical connection withthe messaging system, a network connection, or a high speed deviceconnection (firewire, USB, or similar). The disk stores one or morecaregiver records. As with the patient record retrieving means, themessaging system is programmed to retrieve caregiver records from thedisk using standard database operations or disk operations. Forinstance, if the disk has a relational database, the messaging system isprogrammed to query the database using the patient identifier and thecaregiver type to retrieve the corresponding patient record.

Referring now to FIG. 3, an exemplary flow chart showing one work flowfor sending and receiving electronic messages in accordance with atleast one embodiment of the present invention illustrated. Referringalso to FIG. 1, at block 302, a caregiver may compose an electronicmessage using one of the messaging servers 104 in which the caregiveraddresses the intended recipient using one of the general recipientdescriptors (e.g., PCP). At block 303 the messaging server 104automatically adds contextual information to the electronic message.Here, again, for example, the contextual information may include apatient identifier or some other type of information that may be usefulin resolving which of several PCPs to which the electronic messageshould be transmitted. In the alternative, the message may alreadyinclude contextual information. At block 304 the caregiver selects asend icon or the like to send the electronic message to a recipient.

Referring still to FIGS. 1 and 3, at decision block 306, the messagingserver 104 determines whether or not the message is targeted to anexternal recipient or an internal recipient serviced by server 104.Where the message is intended for an internal recipient, control passesto block 324 where messaging server 104 uses the general descriptor andcontextual information to identify an intended recipient address. Atblock 326, if no recipient is found, control passes to block 330 wherean error message is returned to the physician indicating that nointended recipient address has been identified. At block 326, when arecipient is found, control passes to block 328 where the electronicmessage is delivered to an electronic address associated with theintended recipient.

Referring once again to decision block 306, where the message isintended for an external recipient, control passes to block 308 wherethe message is transmitted through a communication network (see 114 inFIG. 1) to a second messaging server 106 associated with the externaladdress. After the message is received at the second messaging server106 at block 310, control passes to block 312 where the receiving serveruses the general descriptor and contextual information to identify anintended recipient address. Once an intended recipient address has beenidentified at block 320, control passes to block 322 where the messageis delivered to the intended recipient via the address. Where norecipient is identified by block 320, control passes to block 334 wherean error message is returned.

The foregoing description was primarily directed to a preferredembodiment of the invention. Although some attention was given tovarious alternatives within the scope of the invention, it isanticipated that one skilled in the art will likely realize additionalalternatives that are now apparent from disclosure of embodiments of theinvention. For example, the invention is to cover any case where ageneral recipient descriptor is associated by a message composer (e.g.,a caregiver) with an electronic message and contextual information isassociated with the message where the general recipient descriptor andcontextual information are then used to automatically resolve one or asmall subset of intended message recipients irrespective of which ofseveral servers in a networked system performs the resolving process.For instance, as indicated above, a server used to compose an e-mail mayresolve an intended recipient if the server has sufficient information.As another instance, a messaging server receiving an electronic messageincluding the general recipient descriptor and contextual informationmay resolve the intended recipient. EMR systems may help resolveintended recipients as well.

As another example, in at least some embodiments it is contemplated thata first server used to compose a message may communicate with a secondserver after a general recipient descriptor is provided (e.g., enteredin an e-mail address field) and before the electronic message is sent oreven finally composed where the second server can resolve an intendedrecipient and provide the recipient's address back to the first serverto be used during subsequent transmission of the electronic message.Here, for instance, after “PCP@LHC” is specified by a physician, a firstserver may glean patient identifier information and send a pre-e-mail tothe LHC EMR system to retrieve an intended recipient address. The LHCEMR system uses the general recipient descriptor PCP and patientidentifier to identify an address for the patient's PCP which istransmitted back to the first server. The first server can eitherpresent the intended recipient address to the physician for selection orautomatically replace the “PCP@LHC” descriptor with the intendedrecipient address.

Moreover, in some cases an affirmation step may be required where, aftera general recipient descriptor is entered into an address field andprior to transmitting a message intended for a recipient, the inventivesystem uses the descriptor and contextual information associated withthe message to identify a likely intended recipient and presents therecipient for selection by the message composer as opposed toautomatically replacing the descriptor with the recipient's address.Here, the affirmation requirement is an added step which should minimizethe possibility of a message being inadvertently transmitted to anincorrect or unintended recipient.

In still other cases, when a message composer selects a send icon tosend a message to a recipient identified via a general descriptor (e.g.,PCP), the system may first resolve a likely intended recipient andprovide a recipient identifier (e.g., a caregiver's name) for selectionprior to transmission, again requiring an affirmative selection of thespecific recipient prior to transmission.

As one other example, while patient identifiers or patient informationis described above as the contextual information used to resolve anintended recipient along with a general recipient descriptor, otherembodiments may use other types of contextual information from a patientchart or the like. For instance, a medical facility may have achildren's hospital that specializes in treating children under the ageof thirteen. Here, when a PCP designates ENT as a recipient descriptorin an e-mail associated with a child, the system may automatically gleanthe child status from the patient's chart and select an ENT specialistat the facility that works in the children's hospital as the intendedrecipient for the message.

As still another example, contextual information may be related to thegeographic location of a system that receives an electronic message. Forinstance, where a user composes an electronic message at a first systemand specifies “GI 58944” as the recipient, the system may use therecipient indication to identify a GI specialist nearest the zip code58944 as the intended recipient and may therefore complete the messageaddress with an address targeting the intended recipient.

As another example, an intended recipient need not be a singleindividual and instead may be a group of individuals associated with asingle target or recipient address. For instance, in the above examplewhere a recipient indicator is “GI 58944”, the recipient address may bea general address for a GI group closest to the specified zip code,effectively delivering the message to all of the members of the group.

Furthermore, as indicated above, the inventive system may be used inmany other industries.

Accordingly, the scope of the invention should be determined from thefollowing claims and not limited by the above disclosure.

I claim:
 1. A computer-implemented electronic messaging methodcomprising the steps of: receiving an electronic message at a firstsystem, the electronic message comprising a general recipient descriptorindicating a healthcare provider type of an intended healthcare providerrecipient of the electronic message, the general descriptor beingdifferent from an intended recipient address for the intended healthcareprovider recipient, and the electronic message, as received, notincluding the intended recipient address for the intended healthcareprovider recipient; obtaining contextual information associated with theelectronic message at the first system; querying an electronic medicalrecord system to identify a plurality of healthcare provider recipientscorresponding to the general recipient descriptor at the first system,identifying the intended recipient address for the intended healthcareprovider recipient of the electronic message from the plurality ofhealthcare provider recipients, based upon the the contextualinformation; and after identifying the intended recipient address,delivering the electronic message to the intended healthcare providerrecipient at the intended recipient address.
 2. The computer-implementedelectronic messaging method of claim 1 wherein the contextualinformation comprises a patient identifier comprises a token included inthe electronic message.
 3. The computer-implemented electronic messagingmethod of claim 1 wherein the contextual information identifies apatient identifier is retrieved from a patient chart.
 4. Thecomputer-implemented electronic messaging method of claim 3 wherein thepatient chart is the patient chart most recently accessed by ahealthcare provider composing the electronic message.
 5. Thecomputer-implemented electronic messaging method of claim 1 furthercomprising the step of acquiring contextual information from informationin the electronic message.
 6. The computer-implemented electronicmessaging method of claim 1 wherein the contextual information comprisesa patient chart associated with the electronic message.
 7. Thecomputer-implemented electronic messaging method of claim 1 wherein thestep of receiving an electronic message at a first system includescomposing the electronic message at the electronic medical recordssystem and transmitting the electronic message to the first system. 8.The computer-implemented electronic messaging method of claim 1 whereinthe electronic message is composed using the first system.
 9. Thecomputer-implemented electronic messaging method of claim 1 wherein theelectronic message is composed using a second system separate from thefirst system and wherein the step of receiving the electronic messageincludes receiving the electronic message from the second system at thefirst system.
 10. The computer-implemented electronic messaging methodof claim 1 wherein the specialist includes one or more of a cardiacspecialist, an ear, nose, and throat specialist, a pulmonary specialist,an endocrinology specialist, an anesthesiology specialist, and apodiatry specialist.
 11. The computer-implemented electronic messagingmethod of claim 1 wherein the general recipient descriptor furtherindicates a healthcare location associated with the intended healthcareprovider recipient, wherein the healthcare location includes one or moreof a hospital, a healthcare cooperative, an emergency room, a surgerydepartment, a pharmacy, and a laboratory; and wherein the intendedrecipient address for the intended healthcare provider recipient of theelectronic message is identified based upon the healthcare location aswell as the healthcare provider type and the contextual information. 12.The computer-implemented electronic messaging method of claim 1, furthercomprising the step of automatically inserting the intended recipientaddress in an address field in the electronic message.
 13. Thecomputer-implemented electronic messaging method of claims 1, furthercomprising the step of presenting the intended recipient address forselection as a target address for the electronic message.
 14. Thecomputer-implemented electronic messaging method of claim 1 wherein thestep of using the healthcare provider type and the patient identifier toidentify the intended recipient address for the intended healthcareprovider recipient of the electronic message includes using thehealthcare provider type and the patient identifier to identify at leasttwo intended recipient addresses for intended healthcare providerrecipients of the electronic message.
 15. The computer-implementedelectronic messaging method of claim 1, further comprising the steps ofproviding contextual information in the message and evaluatingcontextual information to identify a geographic information associatedwith the location of the first system.
 16. The computer-implementedelectronic messaging method of claim 2, further comprising the step ofproviding a token on a card carried by the patient and reading the tokeninto the electronic medical records system.